Provider Demographics
NPI:1619301710
Name:GALLOWAY, KRISTEN RICHARDS (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RICHARDS
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W GWINNETT ST
Mailing Address - Street 2:C
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-6389
Mailing Address - Country:US
Mailing Address - Phone:425-891-1752
Mailing Address - Fax:
Practice Address - Street 1:303 W GWINNETT ST
Practice Address - Street 2:C
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-6389
Practice Address - Country:US
Practice Address - Phone:425-891-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0121682251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics